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Latent TB is the basis for the world’s deadliest infectious disease – but we can treat it

Image: The Global Fund / Sarah Hoibak

Dr Lucica Ditiu

Executive Director, STOP TB Partnership

With almost one third of the world carrying the latent tuberculosis infection, education, awareness, access and research are vital to eradicate the planet’s deadliest infectious disease once and for all.

Latent tuberculosis infection (LTBI) is the name for the stage when tuberculosis (TB) bacteria have entered the body, but are lying dormant without causing any symptoms. If they start growing, LTBI will turn into active TB, the world’s deadliest infectious disease, and one of the top 10 causes of death worldwide.

Lucica Ditiu, Executive Director of the STOP TB Partnership, says LTBI is a real danger. “The biggest concern is the scale. A huge number of people are infected globally and, although latent TB is a dormant infection, it has the potential to become active. The biggest threat lies in the fact the numbers we are talking about are so big.”

Testing is difficult and some countries do not feel the cost is justifiable

Around 10% of people with LTBI will develop active TB during their lifetime. However, for some people, including under-fives and HIV patients or other immune-suppressed groups, the risk is much higher.

However, current testing tools are the best ever available but still challenging to use, requiring blood samples. Rather than a typical, point-of-care testing as saliva or urine samples. On top of this, some country programmes are reluctant to spend money on treating latent infection that has no symptoms and does not represent a public health threat.

Due to a collective push coordinated by Stop TB partnership, the first ever United Nations High-Level Meeting on TB in 2018 saw member states agree that 30 million people should be able to access TB preventive treatment by 2022. Private sector partners have now also joined the fight against TB.

Education and awareness around latent TB must be improved

Patient website www.LTBI.com has recently been launched to support patients with LTBI and educate people on the infection. An e-learning platform was also launched at the 50th Union World Conference on Lung Health in October 2019 to train clinicians, healthcare workers and national TB programme managers in the successful treatment of LTBI.

“We need to ensure that we are letting people know about this problem,” says Ditiu. “Very few people are aware of TB, so education and the spread of information are important.

“We also need urgent research to understand much better the basic science on TB – why some people get infected and others do not, why some develop the disease and others do not. If we can find a way to predict who gets infected and, from those infected who gets sick, that will be huge.”

World TB Day, celebrated on 24 March, aims to build public awareness of TB and efforts to eliminate the disease.

“The more undiagnosed people are left without diagnosis and treatment, the more TB infection we will see,” explains Ditiu. “Country programmes should include comprehensive packages for TB response, including treatment for Latent TB. We must keep in mind that we will never end TB without addressing those infected with TB.

“On World TB Day, we hope people outside the TB community will understand more about LTBI and all UNHLM on TB targets, and heads of state will realise their responsibilities and take their commitments seriously.”

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